Department of Pediatric Infectious Diseases, Wroclaw Medical University, Ludwika Pasteura 1, 50-367 Wrocław, Poland.
Department of Physiology and Pathophysiology, Wroclaw Medical University, Ludwika Pasteura 1, 50-367 Wrocław, Poland.
Int J Mol Sci. 2024 Aug 12;25(16):8781. doi: 10.3390/ijms25168781.
The clinical significance of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in pediatric patients remains an area of evolving understanding, particularly regarding their utility in the presence or absence of pre-existing heart conditions. While clear cutoff values and established roles in heart failure are understood in adult patients, pediatric norms vary with age, complicating interpretation. Notably, the emergence of multi-system inflammatory syndrome in children (MIS-C) has highlighted the importance of these markers not only in the detection of acute heart failure but also as a marker of disease severity and even as a differential diagnosis tool. This review summarizes current knowledge on the utility of BNP and NT-proBNP in pediatric patients. Their unique physiology, including circulation and compensation mechanisms, likely influence BNP and NT-proBNP release, potentially even in non-heart failure states. Factors such as dynamic volemic changes accompanying inflammatory diseases in children may contribute. Thus, understanding the nuanced roles of BNP and NT-proBNP in pediatric populations is crucial for the accurate diagnosis, management, and differentiation of cardiac and non-cardiac conditions.
B 型利钠肽（BNP）和 N 端脑利钠肽前体（NT-proBNP）在儿科患者中的临床意义仍在不断深入研究，特别是在存在或不存在预先存在的心脏疾病的情况下，其应用价值。虽然在成年患者中，BNP 和 NT-proBNP 在心力衰竭中的明确截断值和既定作用已得到理解，但儿科的正常范围随年龄而变化，这使得解释变得复杂。值得注意的是，儿童多系统炎症综合征（MIS-C）的出现突显了这些标志物的重要性，不仅在于急性心力衰竭的检测，还在于疾病严重程度的标志物，甚至作为鉴别诊断工具。本综述总结了 BNP 和 NT-proBNP 在儿科患者中的应用价值。它们独特的生理学，包括循环和代偿机制，可能会影响 BNP 和 NT-proBNP 的释放，甚至在非心力衰竭状态下也是如此。儿童炎症性疾病伴随的动态血容量变化等因素可能会起作用。因此，了解 BNP 和 NT-proBNP 在儿科人群中的细微作用对于准确诊断、管理和区分心脏和非心脏疾病至关重要。
